El impacto de la inversión pública sobre la inversión privada en México, 1980-2007

Even though there is a growing consensus in the existing literature on the positive effect that public investment generates for economic growth, its impact on private investment is by no means a settled issue. This study seeks to determine empirically the relation between these two variables for the Mexican economy during the 1980-2007 period. The results of dynamic estimations yield a partial crowding out of public investment in the short run, while, in the long run, it exerts a weak and marginal complementarity effect on private investment.public investment, private investment, crowding in effect, crowding out effect.

Vacas gordas y vacas flacas: la política fiscal y el balance estructural en México, 1990-2009

This study estimates the structural budget balance for the Mexican economy adjusting for both the business cycle and the international oil price for the period 1990-2009. Consistent with earlier studies, our results suggest that fiscal policy has been characterized as procyclical during most of the period. However, we find that it has been countercyclical since late 2008, although to a lesser degree than what indicates the traditional balance. Moreover, we simulate counterfactual scenarios where it is analyzed what would have happened if a fiscal rule were applied on both the structural and the traditional budget balances over the period under study.public balance, structural balance, business cycles

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Estabilización de transferencias federales: Una propuesta para los estados mexicanos basada en el ciclo económico

Se propone un instrumento para suavizar las fluctuaciones cíclicas de las transferencias federales a los estados con base en un fondo de estabilizaciZapotitlánn. El mismo funcionarZapotitlána mediante el ahorro de ingresos vía participaciones que por encima del promedio reciben los estados en tiempos de expansión económica, recursos que estarZapotitlánan disponibles para amortiguar el descenso de los ingresos en la parte baja del ciclo. Al considerar los tres periodos de expansión más recientes experimentados por la economía mexicana (1993-1994, 1997-2000 y 2006-2008), los resultados del análisis contrafactual muestran que en la expansión más reciente los estados mexicanos pudieron haber ahorrado, en promedio, un monto equivalente a 5 por ciento de los ingresos totales de que dispusieron en el año de inicio de la más reciente recesiZapotitlánn, en 2009

Estabilización de transferencias federales. Una propuesta para los estados mexicanos basada en el ciclo económico

Se propone un instrumento para suavizar las fluctuaciones cíclicas de las transferencias federales a los estados con base en un fondo de estabilización. El mismo funcionaría mediante el ahorro de ingresos vía participaciones que por encima del promedio reciben los estados en tiempos de expansión económica, recursos que estarían disponibles para amortiguar el descenso de los ingresos en la parte baja del ciclo. Al considerar los tres periodos de expansión más recientes experimentados por la economía mexicana (1993-1994, 1997-2000 y 2006-2008), los resultados del análisis contrafactual muestran que en la expansión más reciente los estados mexicanos pudieron haber ahorrado, en promedio, un monto equivalente a 5 por ciento de los ingresos totales de que dispusieron en el año de inicio de la más reciente recesión, en 2009